Individual
EBAN JAMES MACKEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3475 BELLE CHASE WAY, LANSING, MI 48911-4252
(517) 882-3732
Mailing address
544 EAST DR, MARSHALL, MI 49068-1363
(269) 274-2963
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704280061
MI
Other
Enumeration date
11/19/2021
Last updated
03/22/2022
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